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目的探讨院前无创机械通气辅助重组人B型钠尿肽联合替罗非班治疗急性心肌梗死并左心衰竭的临床价值。方法将208例急性心肌梗死并左心衰竭患者随机分为试验组和对照组各104例。2组给予重组人B型钠尿肽联合替罗非班治疗。试验组患者均给予院前无创机械通气治疗。对照组给予常规院前治疗。对比2组临床疗效,左心室功能和不良反应。结果治疗前2组患者左心室功能LVEF、LVEDV和LVESV水平差异均无统计学意义(P>0.05)。治疗后2组患者LVEF显著升高,而LVEDV和LVESV水平均降低,且试验组变化幅度明显大于对照组(P<0.05)。试验组总有效率高于对照组,不良反应发生率低于对照组(P<0.05)。结论院前无创机械通气辅助重组人B型钠尿肽联合替罗非班治疗急性心肌梗死并左心衰竭可显著改善患者左心功能,提高治疗效果。
Objective To investigate the clinical value of noninvasive mechanical ventilation-assisted recombinant human B-type natriuretic peptide combined with tirofiban in the treatment of acute myocardial infarction and left heart failure. Methods 208 patients with acute myocardial infarction and left heart failure were randomly divided into experimental group and control group of 104 cases. Two groups were given recombinant human B-type natriuretic peptide combined with tirofiban treatment. Patients in the experimental group were given preoperative noninvasive mechanical ventilation. The control group was given conventional pre-hospital treatment. The clinical efficacy, left ventricular function and adverse reactions in two groups were compared. Results There was no significant difference in left ventricular function LVEF, LVEDV and LVESV between the two groups before treatment (P> 0.05). After treatment, the LVEF of two groups were significantly increased, while the levels of LVEDV and LVESV were decreased, and the changes in the experimental group were significantly greater than those in the control group (P <0.05). The total effective rate of the experimental group was higher than that of the control group, and the incidence of adverse reactions was lower than that of the control group (P <0.05). Conclusion Prehospital non-invasive mechanical ventilation-assisted recombinant human B-type natriuretic peptide combined with tirofiban in the treatment of acute myocardial infarction and left heart failure can significantly improve left ventricular function and improve the therapeutic effect.